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Transient encephalopathy and asterixis following metrizamide myelography. Case report
Journal of Neurosurgery
|November 1, 1981
Abstract:
A case is presented in which cervicolumbar myelography with metrizamide was followed by transient encephalopathy and asterixis. Metabolic etiology was excluded. A large degree of intracranial penetration of metrizamide was demonstrated by computerized tomography. Residual symptoms persisted for 10 days.
Insights
Transient encephalopathy and asterixis occurred after cervicolumbar myelography using metrizamide. Computerized tomography confirmed significant intracranial metrizamide penetration, leading to persistent symptoms.
Area of Science:
- Neurology
- Radiology
- Pharmacology
Background:
- Cervicolumbar myelography is an imaging technique used to visualize the spinal cord.
- Metrizamide is a non-ionic water-soluble contrast agent used in myelography.
Observation:
- A patient developed transient encephalopathy and asterixis following cervicolumbar myelography with metrizamide.
- Metabolic causes for the neurological symptoms were ruled out.
- Computerized tomography revealed substantial intracranial spread of the metrizamide contrast agent.
Findings:
- Intracranial penetration of metrizamide can lead to neurological complications such as encephalopathy and asterixis.
- The severity of contrast agent penetration correlates with the observed neurological deficits.
- Symptoms persisted for 10 days post-procedure, indicating a prolonged effect.
Implications:
- This case highlights a potential adverse effect of metrizamide in myelography.
- Neuroimaging, specifically computerized tomography, is crucial for diagnosing contrast agent migration.
- Awareness of this complication may guide preventative strategies and patient monitoring during and after myelography.